Provider Demographics
NPI:1669942520
Name:BARNES, KIMBRALON (LPC)
Entity type:Individual
Prefix:
First Name:KIMBRALON
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KIMBRALON
Other - Middle Name:
Other - Last Name:HODGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3101 N CENTRAL AVE STE 550
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2635
Mailing Address - Country:US
Mailing Address - Phone:602-230-7373
Mailing Address - Fax:
Practice Address - Street 1:3330 N 2ND ST STE 601
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2395
Practice Address - Country:US
Practice Address - Phone:602-230-7373
Practice Address - Fax:602-257-8029
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-17680101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional